Neil, AL and Nelson, MR and Richardson, T and Mann-Leonard, M and Palmer, AJ, General practice after-hours incentive funding: a rationale for change, Medical Journal of Australia, 203, (2) pp. 82-85. ISSN 0025-729X (2015) [Refereed Article]
Copyright 2015 MJA
- After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP).
- In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance.
- In this article, we examine the drivers of the 1998–2013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania.
- The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice.
- Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas.
- The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives.
- A new after-hours incentive funding mechanism embodying pre-specified objectives — such as support for (unavoidable) burden and/or provision of care to residential aged care facilities — is required. Claimed provision is considered an inappropriate funding determinant.
|Item Type:||Refereed Article|
|Keywords:||medicare locals, general practice, rural, equity|
|Research Group:||Applied Economics|
|Research Field:||Health Economics|
|Objective Group:||Health and Support Services|
|Objective Field:||Health Policy Economic Outcomes|
|UTAS Author:||Neil, AL (Dr Amanda Neil)|
|UTAS Author:||Nelson, MR (Professor Mark Nelson)|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|Deposited By:||Menzies Institute for Medical Research|
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